武陵民族地区中学生健康危险行为现状及影响因素分析

Health risk behaviors and associated factors among middle school students in Wuling ethnic area

目的了解武陵民族地区中学生健康危险行为流行情况及其相关影响因素,为开展有效干预提供参考。方法按照多阶段分层整群随机抽样原则,于2015年11—12月从地处武陵民族地区腹地的湘西土家族苗族自治州抽取4个县8所城乡中学2 360名土家族和苗族中学生,进行健康危险行为现状调查,对可能的影响因素进行非条件Logistic回归分析。结果武陵民族地区中学生偏食、缺乏锻炼、自杀意念、吸烟、饮酒和网络成瘾报告率分别为29.11%,58.94%,19.49%,20.04%,26.36%,6.02%。Logistic回归分析显示,偏食的危险因素有独生子女、网络成瘾,保护因素有男生(OR值分别为1.562,2.219,0.695,P值均<0.01);缺乏锻炼的危险因素有高中、住宿、自杀意念(OR值分别为1.452,1.291,1.494),保护因素有男生(OR=0.513)、学习成绩(中等OR=0.750,中等偏上或好OR=0.689)(P值均<0.01);自杀意念的危险因素有高中(OR=1.419)、吸烟(OR=1.857)、孤独(很少或有时OR=1.529,经常或总是OR=2.366)、抑郁(OR=2.694)、上下学感到不安全(很少或有时OR=1.381、经常或总是OR=1.974)、打架(OR=1.744),保护因素有男生(OR=0.542)(P值均<0.05);吸烟的危险因素有男生、留守、饮酒、打架、自杀意念(OR值分别为6.984,1.372,5.810,1.687,1.837),保护因素有学习成绩(中等OR=0.580,中偏上或好OR=0.467)(P值均<0.05);饮酒的危险因素有土家族(OR=1.708)、母亲文化程度(初中或高中OR=1.319,大专及以上OR=2.600)、吸烟(OR=6.678)、抑郁(OR=1.524)、打架(OR=1.878),保护因素有学习成绩(中等偏上或好OR=0.666)(P值均<0.05);网络成瘾的危险因素有男生(OR=1.970)、偏食(OR=2.013)、失眠(很少或有时OR=1.949,经常或总是OR=2.322)、吸烟(OR=1.525)、自杀意念(OR=2.471)、上网以玩游戏为主(OR=3.071),保护因素有学习成绩(中等OR=0.624,中等偏上或好OR=0.395)(P值均<0.05)。结论自感学习成绩差的中学生易发生多种健康危险行为。应加强学校、家庭、社会联合行动,确定预防和控制工作重点。

Objective To understand health risk behaviors and associated factors among middle school students in Wuling ethnic areas. Methods Using multi-stage stratified cluster sampling method, 2 360 Tujia and Miao adolescents were recruited from 8 cities and rural high schools of four counties in Xingxi Tujia and Miao Autonomous Prefecture from November to December 2014. Questionnaire survey was conducted to collect health risk behaviors. Non-conditional Logistic regression analysis was used to analyze the possible influencing factors of health risk behaviors. Results Reported rates of picky eating behavior, physical inactivity, sui- cidal ideation, smoking, drinking and internet addiction were 29.11%, 58.94%, 19.49%, 20.04%, 26.36% and 6.02%, respec- tively. Logistic regression analysis result showed that risk factors for picky eating behavior included the only child（ OR = 1.562） and internet addiction（ OR = 2.219）, while the protective factor was being boy（ OR = 0.695） （P〈0.01）. Risk factor for physical inactivity was high school（ OR=1.452）, in residence （ OR= 1.291） and suicidal ideation （ OR= 1.494） while protective factors included being boy（ OR = 0.513）, average school record（ OR = 0.750） and superior school record（ OR = 0.689） （ P〈0.01）. Risk factors for suicidal i- deation included high school（ OR= 1.419）, smoking（ OR= 1.857）, felt lonely （seldom or sometimes OR= 1.529; often or always OR = 2.366）, depression （ OR= 2.694）, feel unsafe at school （ seldom or sometimes OR= 1.381; often or always OR= 1.974） and fight- ing （OR= 1.744） while protective factor was being boy（ OR= 0.542）; Risk factors for smoking were being boy（ OR= 6.984）, left-behind experiences（ OR= 1.372）, drinking（ OR= 5.810）, fighting （ OR= 1.687） and suicidal ideation（ OR= 1.837）, the protective factor was average school record（ OR = 0.580） and superior school record（ OR = 0.467）（ P〈0.05）. Risk factors for drinking included Tujia minority（ OR = 1.708）, maternal education （ junior or senior school： OR = 1.319; college and above： OR = 2.600）, smoking （ OR = 6.678）, depression （ OR = 1.524） and fighting（ OR = 1.878）, the protective factor was superior school record（ OR = 0.666） （ P 〈0.05）. Risk factors for internet addiction included being boy（ OR = 1.970）, picky eating behaviors（ OR = 2.013）, insomnia （ sel- dom or sometimes： OR= 1.949; often or always： 0R=2.322）, smoking（ OR= 1.525）, suicidal ideation （0R=2.471） and frequent game playing（ OR = 3.07l）, the protective factor was school record（ average： OR = 0.624; superior school record： OR = 0.395）（ P〈 0.05）. Conclusion Students with poor academic performance are more likely engaged with multiple health risk behaviors. Compre- hensive actions should be taken by school, family and society emphasizing prevention and intervention at the same time.